The University of Pretoria (UP) has been tasked with bringing all publicly funded cancer research and innovation across South Africa together into a single, coherent national research strategy.

“We want a big strategy and we are not just looking at research, but at the full innovation value chain, from lab to market,” said Dr Rakeshnie Ramoutar-Prieschl, Acting Deputy Director-General of the national Department of Science and Innovation (DSI) and Head of Research Capacity Development at UP.  

She was addressing about 80 UP cancer research stakeholders at a workshop hosted and facilitated by the University’s Faculty of Health Sciences’ Research Support Hub on developing cancer research priorities in early August 2024. This was the first in a series of activities planned to develop a national cancer research and innovation strategy rooted in the World Health Organisation’s cancer control pillars, which focus on prevention, early detection and diagnosis, treatment, and palliative care and survivorship.

“Your job here today is to ask, ‘What is the cancer strategy we want to see in South Africa that addresses skills and the infrastructure that’s needed?’” Dr Ramoutar-Prieschl said to the workshop participants. “How do we drive our research so that we can translate that research into diagnostic tools, early-detection capabilities and prevention treatment?”

However, the draft strategy needed to go beyond research, she added, to look at areas of commercialisation, patents, the creation of spin-off companies, and how to ensure the involvement of small, medium-sized and micro enterprises.

Seeing the big picture

Describing UP as the “custodian and the flagship” of the DSI’s collaborative effort towards a national cancer research strategy, Dr Ramoutar-Prieschl said the University’s task would be to “pull together” all cancer research initiatives dealing with the four themes, from prevention through to palliative care.  

“Tell us what it is we need to consider in government; what we need to consider on the continent. We are steering towards developing a strategy not just for South Africa, but for the continent – and that’s a big ask.”

She urged the workshop participants to be aware of the big picture of cancer research and innovation in South Africa and abroad.

“Take a step back and ask what is happening in other institutions and how we can bring it into this big strategy.”

Glaudina Loots, Director of Health Innovation at the DSI, pointed out that the incidence of cancer and cancer deaths in South Africa was being undercounted by about 30% in the national statistics on cancer. This highlighted the need to think and act differently in dealing with cancer.

“At the end of the day, we want innovations – new and different ways of doing,” she said, adding that the DSI was not interested only in high-tech advances such as nuclear medicine but also traditional medicine and non-conventional treatments. “What are we doing about choices to give to people? What are we doing with things like cancer bush, which has been seen to have some effect. Are we ignoring it? Because more than 50% of our population is not ignoring it. How do we bring it into what is going on?”

Loots also urged the participants to think beyond South Africa.

“Whatever we’re doing here, will we export it to the rest of Africa? Keep that in mind as well.”

“We have many sites with excellent work being done on cancer, and we have world-class facilities,” said cancer researcher Professor Annie Joubert, Head of the Department of Physiology at UP, in reference to UP’s Institute for Cellular and Molecular Medicine, the Pan-African Cancer Research Institute, the Brain Tumour and Translational Neuroscience Centre, and the Nuclear Medicine Research Infrastructure (NuMeRi) facility.

A key issue in developing the draft national research strategy would be collaboration to avoid “pockets of excellence” both at the University, and in South Africa more broadly, conducting research in solos, Prof Joubert said. It would also be important to keep in mind the socio-economic dimensions of addressing cancer.

“There must be emphasis on equal health and on addressing the cancer incidence and mortality rates, specifically for the most vulnerable populations,” she added.

Focusing on co-creation and collaboration

Getting down to the task at hand, the participants worked in groups, with each group focusing on one of the four themes of prevention, early detection and diagnosis, treatment, and palliative care and survivorship.

The main facilitator was Prof Tivani Mashamba-Thompson, Deputy Dean of Research and Postgraduate Studies in the Faculty of Health Sciences. The leaders of the groups included Prof Llewellyn Padayachy, Head of the Department of Neurosurgery; Prof Nathaniel Mofolo, Head of the Department of Family Medicine; Dr Honest Ndlovu of NuMeRI; and Dr Sean Patrick, a senior lecturer at the School of Health Systems and Public Health.

While a report on the workshop outcomes will be made available, some common  threads mentioned in the groups were the use of artificial intelligence, for example for patient referrals and to reduce the time between diagnosis and treatment; the importance of providing practical prevention information to communities, especially in rural areas where patients present late; and the development of software applications that are relevant to communities and allow them to interact more easily with healthcare practitioners.

Wrapping up the workshop, Dr Ramoutar-Prieschl reiterated that the draft strategy should have a place for every actor in the cancer research, development and innovation space, from lab to market.

“It’s the first time we are carrying out such an initiative, so it’s big. It also is a big responsibility on our shoulders,” she said, noting that the ultimate outcome is to go to parliament and say, ‘This is what we are doing for the people of South Africa, and these are the tangible outcomes.”